Elevated C-peptide and insulin predict increased risk of colorectal adenomas in normal mucosa

BMC Cancer

Adriana C Vidal²  Pauline Kay Lund¹  Cathrine Hoyo²  Joseph Galanko³  Lauren Burcal³  Rachel Holston³  Berri Massa³  Oluwaseun Omofoye³  Robert S Sandler³  Temitope O Keku³ 

[1] Department of Cell and Molecular Physiology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina

[2] Department of Obstetrics and Gynecology, and Program of Cancer Detection, Prevention and Control, for Duke University School of Medicine, Durham, North Carolina

[3] Department of Medicine and Center for Gastrointestinal Biology & Disease School of Medicine, University of North Carolina, Chapel Hill, North Carolina

关键词: Insulin-like growth factor binding protein;    C-peptide;    Insulin;   

Others  :  1080219
DOI  :  10.1186/1471-2407-12-389

 received in 2012-04-26, accepted in 2012-08-31,  发布年份 2012

【 摘 要 】

Background

Lower concentrations of the insulin–like growth factor binding protein-1 (IGFBP-1) and elevated concentrations of insulin or C-peptide have been associated with an increase in colorectal cancer risk (CRC). However few studies have evaluated IGFBP-1 and C-peptide in relation to adenomatous polyps, the only known precursor for CRC.

Methods

Between November 2001 and December 2002, we examined associations between circulating concentrations of insulin, C-peptide, IGFBP-1 and apoptosis among 190 individuals with one or more adenomatous polyps and 488 with no adenomatous polyps using logistic regression models.

Results

Individuals with the highest concentrations of C-peptide were more likely to have adenomas (OR = 2.2, 95% CI 1.4-4.0) than those with the lowest concentrations; associations that appeared to be stronger in men (OR = 4.4, 95% CI 1.7-10.9) than women. Individuals with high insulin concentrations also had a higher risk of adenomas (OR = 3.5, 95% CI 1.7-7.4), whereas higher levels of IGFBP-1 were associated with a reduced risk of adenomas in men only (OR = 0.3, 95% CI 0.1-0.7). Overweight and obese individuals with higher C-peptide levels (>1^st Q) were at increased risk for lower apoptosis index (OR = 2.5, 95% CI 0.9-7.1), an association that remained strong in overweight and obese men (OR = 6.3, 95% CI 1.0-36.7). Higher levels of IGFBP-1 in overweight and obese individuals were associated with a reduced risk of low apoptosis (OR = 0.3, 95% CI 0.1-1.0).

Conclusions

Associations between these peptides and the apoptosis index in overweight and obese individuals, suggest that the mechanism by which C-peptide could induce adenomas may include its anti-apoptotic properties. This study suggests that hyperinsulinemia and IGF hormones predict adenoma risk, and that outcomes associated with colorectal carcinogenesis maybe modified by gender.

【 授权许可】

   
2012 Vidal et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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